Document Detail


Long-term frequency gradients during persistent atrial fibrillation in sheep are associated with stable sources in the left atrium.
MedLine Citation:
PMID:  23051840     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Dominant frequencies (DFs) of activation are higher in the atria of patients with persistent than paroxysmal atrial fibrillation (AF), and left atrial (LA)-to-right atrial (RA) DF gradients have been identified in both. However, whether such gradients are maintained as long-term persistent AF is established remains unexplored. We aimed at determining in vivo the time course in atrial DF values from paroxysmal to persistent AF in sheep and testing the hypothesis that an LA-to-RA DF difference is associated with LA drivers in persistent AF.
METHODS AND RESULTS: AF was induced using RA tachypacing (n=8). Electrograms were obtained weekly from an RA lead and an implantable loop recorder implanted near the LA. DFs were determined for 5-second-long electrograms (QRST subtracted) during AF in vivo and in ex vivo optical mapping. Underlying structural changes were compared with weight-matched controls (n=4). After the first AF episode, DF increased gradually during a 2-week period (7±0.21 to 9.92±0.31 Hz; n=6; P<0.05). During 9 to 24 weeks of AF, the DF values on the implantable loop recorder were higher than the RA (10.6±0.08 versus 9.3±0.1 Hz, respectively; n=7; P<0.0001). Subsequent optical mapping confirmed a DF gradient from posterior LA-to-RA (9.1±1.0 to 6.9±0.9 Hz; P<0.05) and demonstrated patterns of activation compatible with drifting rotors in the posterior LA. Persistent AF sheep showed significant enlargement of the posterior LA compared with controls.
CONCLUSIONS: In the sheep, transition from paroxysmal to persistent AF shows continuous LA-to-RA DF gradients in vivo together with enlargement of the posterior LA, which harbors the highest frequency domains and patterns of activation compatible with drifting rotors.
Authors:
David Filgueiras-Rama; Nicholas F Price; Raphael P Martins; Masatoshi Yamazaki; Uma Mahesh R Avula; Kuljeet Kaur; Jérôme Kalifa; Steven R Ennis; Elliot Hwang; Vijay Devabhaktuni; Jose Jalife; Omer Berenfeld
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-10-10
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  5     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-19     Completed Date:  2013-02-26     Revised Date:  2014-08-07    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1160-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Animals
Atrial Fibrillation / physiopathology*
Cardiac Pacing, Artificial
Disease Models, Animal
Disease Progression*
Electrophysiologic Techniques, Cardiac
Heart Atria / physiopathology*
Heart Conduction System / physiopathology*
Sheep
Time Factors
Voltage-Sensitive Dye Imaging
Grant Support
ID/Acronym/Agency:
P01 HL039707/HL/NHLBI NIH HHS; P01 HL087226/HL/NHLBI NIH HHS; P01-HL039707/HL/NHLBI NIH HHS; P01-HL087226/HL/NHLBI NIH HHS; R01 HL087055/HL/NHLBI NIH HHS
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